Living with chronic pain impacts every aspect of a person’s life, physically, emotionally, environmentally, and socially. Because of this, clinicians now advocate a “bio-psychosocial” approach to chronic pain management, as opposed to the traditional “biomedical model” limited to physical symptoms.
If you have visited our clinic recently, you have hopefully met Shobhna Thakur, a licensed physical therapist who works alongside Dr. Robertson to help you strengthen muscles and increase joint movement to be more physically active and experience less pain. What, you might wonder, could an occupational therapist do on top of that?
While physical therapists and chiropractic physicians focus on physical function, occupational therapists specialize in helping you to interact with the environment, which includes your home, workplace, church, grocery store, etc., so you can continue to “be in the world.” They help you to build confidence in your ability to live independently, which is essential to quality of life.
According to the American Occupational Therapy Association (2020), occupation is defined as a meaningful activity focused on things a person wants and needs to do in their daily life. According to occupational therapist, Dr. Tina Sauber (2023), meaningful activities range from a persons’ activities of daily living (ADLs) or self-care, to complex tasks for independent living at home, work related tasks and activities within the community (instrumental activities of daily living or IADLs). The goal is to improve a persons’ functional performance, independence, and quality of life though participation in everyday tasks. Occupational therapists work with people across the lifespan addressing acute and chronic conditions in hospitals, clinics, schools, and community-based organizations. The approach is grounded in research and evidence-based practices, using a whole-person approach that incorporates physical, emotional and behavioral perspectives.
The occupational therapy process begins with developing what the American Occupational Therapy Association describes as an “occupational profile,” that focuses on four areas:
* Your ability to cope with pain
* Your perception of your pain
* Your thought processes and emotional responses to pain
* Your self-efficacy for pain, meaning your belief in being able to function despite a certain amount of discomfort (AOTA, 2021).
Although life is never the same after chronic pain takes hold, it is important to appreciate your value to friends, family, and colleagues. The pain is not a reason to give up; but rather an opportunity to reassess, adjust and move forward.
If you work at a job that involves physical tasks, the OT may utilize a process known as “work hardening,” to help you re-integrate into your work environment (Feinberg, Gatchel et al., 2015). This includes specific strengthening exercises along with adaptive equipment that you need to go back to work. For example, you might need a more ergonomic office desk and chair to avoid back and neck pain while working at the computer.
Another important concept is activity pacing and energy conservation: taking brief rests, when necessary, to get through the day, and finding solutions to tasks around the house and office that don’t exacerbate your chronic pain. If you find it difficult to stand at the stove while you are cooking, a stool that is the correct height could make this more comfortable. If folding laundry is difficult, place a folding surface near a chair or stool. A couple of 5-minute rests won’t add a lot of time to completing the job and can make a significant difference in your comfort level.
Other areas for consideration are your sleep environment, your car (seat adjustment, steering wheel height, access and egress, etc.), and the bathroom. You may need a grab handle to get in and out of the tub safely or a shower chair. Make sure the items you need every day are within easy reach.
To find a licensed occupational therapist in your community, click on this Healthgrades link.
Special thanks to Dr. Tina Sauber for her editorial contributions to this article.